To the Editor The study by Hall et al1 sheds light on a very important step in the research process. The authors found that most initial institutional review board (IRB) approvals take 2 to 4 months, which is longer than the recommended 60 days. They suggest that a detailed analysis of review time, using a procedure similar to their methods, could be a useful quality improvement measure for research implementation.1 Indeed, their analysis revealed that most delays were due to slow response time by investigators and were not a structural IRB problem.